Percutaneous ultrasound-guided cholecystocentesis: complications and association of ultrasonographic findings with bile culture results

Objectives To retrospectively evaluate cases presented for percutaneous ultrasound‐guided cholecystocentesis for associated complications, identify risk factors associated with complications and to assess ultrasonographic findings and relate these to bacterial culture results. Methods Data on 300 patients presented for percutaneous ultrasound‐guided cholecystocentesis were retrospectively collected and ultrasonographic images were assessed for defined structural changes. The incidence of major complications was determined. Multi‐variable multi‐level logistic regression was used to investigate the association of ultrasonographic findings with positive bile culture. Results Three hundred percutaneous ultrasound‐guided cholecystocentesis procedures performed in 201 dogs and 51 cats were included; 35 patients had the procedure performed more than once. The overall incidence of major complications was 8 of 300 procedures (2·7%). Bile peritonitis occurred in 2 of 300 procedures (0·7%). An ultrasonographically abnormal gall bladder was found in 52% of cases and had a sensitivity, specificity and accuracy of 82, 55·7 and 61·5% respectively, to predict a positive bile culture. Clinical Significance Percutaneous ultrasound‐guided cholecystocentesis is overall a safe technique when carried out in selected patients. Abnormal ultrasonographic findings are only a fair predictor of a positive bile culture

Graft remodeling during growth following anterior cruciate ligament reconstruction in skeletally immature sheep

INTRODUCTION: Ruptures of the anterior cruciate ligament are being diagnosed with increasing frequency in skeletally immature individuals. It was our aim to investigate the graft remodelling process following an autologous, transphyseal reconstruction of the anterior cruciate ligament (ACL) in skeletally immature sheep. We hypothesized that the ligamentisation process in immature sheep is quicker and more complete when compared to adult sheep. MATERIALS AND METHODS: Skeletally immature sheep with an age of 4 months underwent a fully transphyseal ACL reconstruction using an autologous tendon. The animals were subsequently sacrificed at 3, 6, 12 and 24 weeks following surgery. Each group was characterised histomorphometrically, by immunostaining (VEGF, SMA), by transmission electron microscopy (TEM) and biomechanically (UFS Roboter). RESULTS: The histomorphometric analysis and presence of VEGF and SMA positive cells demonstrated a rapid return to a ligament like structure. The biomechanical analysis revealed an anteroposterior translation that was still increased even 6 months following surgery. CONCLUSION: As in adult sheep models, the remodeling of a soft tissue graft used for ACL reconstruction results in a biomechanically inferior substitute. However, the immature tissue seems to remodel faster and more complete when compared to adults

Cor triatriatum dexter of unusual morphology in a miniature schnauzer.

A five-year-nine-month-old, male entire, miniature schnauzer presented for further investigation of pleural effusion. Echocardiography revealed a perforated membrane dividing the right atrium into two chambers: the true right atrium (a small, lower-pressure, cranioventral chamber communicating with the tricuspid valve and right ventricle) and the accessory right atrium (a larger, higher-pressure, caudodorsal chamber), consistent with a cor triatriatum dexter. This was confirmed using computed tomography angiography. Imaging studies revealed that both the cranial and caudal vena cava entered the higher-pressure accessory right atrium and the coronary sinus entered both the accessory and true right atrial chambers. This differed from the more usual canine cor triatriatum dexter presentation with the cranial vena cava entering the lower-pressure cranial chamber and the caudal vena cava entering the higher-pressure caudal chamber. Balloon membranostomy was successful in reducing the pressure gradient between the two right atrial chambers with subsequent resolution of the clinical signs. The patient continues to do well after three-years of follow-up

Computed tomographic findings in dogs with suspected aspiration pneumonia: 38 cases (2014-2019)

ObjectivesTo describe computed tomographic (CT) findings in dogs diagnosed with aspiration pneumonia and to assess for any correlation with patient outcome.Materials and methodsRetrospective analysis of 38 cases with a presumptive diagnosis of aspiration pneumonia at two UK referral centres. Medical records were reviewed for signalment, history, physical examination and clinicopathologic data. CT examinations of the thorax were reviewed by the European College of Veterinary Diagnostic Imaging board-certified radiologist for all dogs to describe the characteristics and distribution of the pulmonary lesions.ResultsThe most common CT findings were lung lobe consolidation associated with air bronchograms (100%) followed by ground-glass attenuation (89.4%), bronchial wall thickening (36.8%), bronchiolectasis (31.5%) and bronchiectasis (15.7%). Large-breed dogs were overrepresented. Duration of hospitalisation ranged between 0 and 8 days (mean 3 days). Overall, 89.4% of dogs survived the aspiration event and were discharged from the hospital. The four dogs that did not survive to discharge had five or more lobes affected on CT.Clinical significanceCT findings in dogs with aspiration pneumonia are described. CT is a useful imaging modality to diagnose aspiration pneumonia

CT findings in Pneumocystis carinii pneumonia in five dogs

Pneumocystis carinii pneumonia is a rare disease in dogs. It is primarily reported in cavalier King Charles spaniels and miniature dachshunds with suspected underlying immunodeficiency. This case series reports the findings in five dogs (four cavalier King Charles spaniels and one Bedlington terrier) with confirmed P. carinii pneumonia. Thoracic (CT) revealed ground glass opacity of the pulmonary parenchyma with a diffuse or multifocal distribution. The severity of this pattern was variable. Less consistent imaging findings included parenchymal bands, bronchial dilation and signs consistent with pulmonary hypertension. Four dogs recovered well with treatment and there was resolution of CT abnormalities in all dogs with follow-up